Saving Lives Through Tablet-Based Ultrasound Technology

In the medical world, it’s known as the “golden hour.” The sixty minutes following a traumatic injury or emergency that can make the difference between life and death. Sixty minutes in which the faster a patient receives medical treatment, the more likely they are to survive.

In an effort to optimize treatment during that crucial golden hour, Emergency medical services (EMS) providers in the Dallas/Fort Worth area are using new technologies in the field. Using a tablet ultrasound system developed by Samsung, medics are now able to send images wirelessly while the patient is en route to the hospital, allowing the medical team to mobilize even before arrival and hopefully saving more lives.

The clinical evaluation started in July 2014, with six emergency services vehicles at fire departments in the Dallas/Fort Worth Metroplex provided with Samsung’s PT60A tablet-based ultrasound systems. EMS workers acquire images of trauma patients in the field, then transmit the images via a cloud-based image management system to awaiting emergency room physicians.

The program is the brainchild of Dr. Roy Yamada, EMS medical director for Dallas/Fort Worth. No stranger to pushing the boundaries of using technology in the field—his EMS program was one of the first in the nation to equip ambulances with EKG equipment—Yamada says he was first inspired to look into ultrasound technology for ambulances after reading a journal article that said ultrasounds might eventually replace stethoscopes in the field. Wanting to see whether ultrasounds might help preserve the golden hour, he thought it would make sense to train his paramedics to read ultrasounds.

“We’re pretty excited about all the possibilities of the things we can do,” Yamada says.

After gaining approval from local supervisors and hospitals to investigate ultrasound use, Yamada partnered with Samsung to train his paramedic teams on how to use the ultrasound systems to evaluate fluid collection using the eFAST exam. To pass the training, each paramedic was required to do 100 ultrasound scans and document them.

Samsung’s PT60A ultrasound, which became available in the U.S. in 2013, was designed specifically for use for the point of care. It delivers the accuracy of high-performance medical equipment in a mobile form-factor, making it the natural choice for the project.

Saving lives in real time

According to Yamada, the ultrasound technology has been used in a variety of cases, from trauma patients sustaining injuries to the abdomen to patients presenting chest pain. The ultrasound exams have been performed on patients in full cardiac arrest, trauma patients with pelvic fractures, kidney stones and even ectopic pregnancies, allowing medics to make a better assessment in consultation with a physician. Yamada says medics can even take images while the ambulance is moving without the image quality being diminished.

“Because the machine is solid state, we can actually get those images and not have interference,” he says. “It’s quite an amazing instrument."

For example, after using the ultrasound equipment on a patient without a pulse, medics were able to see whether the heart had electrical activity. As a result, resuscitation efforts were continued, rather than calling the medical director to have treatment discontinued. “We’re trying to save the one that no one else can save,” Yamada says.

Diagnosis on the double

The image management system was developed by Trice Imaging, a company based in Del Mar, Calif. Trice co-founder and COO Johanna Wollert Melin says that once uploaded to their cloud-based image management system, paramedics can choose to transmit images. Email addresses and phone numbers for medical personnel are already programmed into the system, allowing images to be directly transmitted to a doctor’s smartphone and quickly sending alerts on the condition of emergency patients through a secure image link, Melin says.

Awaiting doctors can provide additional instructions to the EMS staff or request additional images from the field if necessary. “They can communicate back and forth on the way into the hospital,” Melin says.

Yamada says trauma doctors in the area are excited about the technology and its possibilities. Being able to transmit the images to doctors quickly allows them to make fast decisions about treatment that not only save time but can start treatment sooner. For instance, if a doctor knows that a patient will need surgery, the ER can be bypassed altogether.

“We can use it for shortness of breath to make sure the lungs are inflated, to make sure the heart is functioning well and in blunt trauma—say a head-on collision—if the driver has unstable vital signs and we see blood in the abdomen, we shoot the information to the hospital and activate trauma so the patient can be taken straight to the operating room rather than the ER,” he said.

For his part, Yamada intends to continue outfitting his EMS teams with technologies that can help them act decisively in the golden hour. Plans are in the works to equip ambulance helicopters with ultrasound tablets as well, he says. “We’re taking technology and applying it to saving lives.”

Lisa Melsted is a writer and communications consultant based in the San Francisco Bay Area. A tech industry veteran with turns in public relations, market research and journalism, she writes about enterprise and B2B technologies and moonlights as a food and profile writer.